Considerations of PoCUS vs Manual Pulse Check in Predicting ROSC for Patients Presenting in PEA

Background: Point of care ultrasound (PoCUS) has enabled providers to draw a contrast between true PEA (Pulseless Electrical Activity) and pseudo-PEA. The incorporation of PoCUS pulse checks in PEA and pseudo-PEA has been shown to more accurately predict Return of Spontaneous Circulation (ROSC) when compared to standard manual pulse checks. However, concerns have been raised in recent observational studies regarding increased duration of PoCUS pulse checks compared to manual pulse checks leading to suboptimal CPR and subsequent deterioration of ACLS protocol integrity. Objective: This clinical review aims to examine the utility and practical implementation of PoCUS versus manual pulse check in the prediction of ROSC for patients presenting to the hospital in PEA. Discussion: A PubMed, MEDLINE, Scopus, and CINAHL databases literature search was conducted with the following search terms: point of care ultrasound (PoCUS), pulseless electrical activity (PEA), Pseudo Pulseless Electrical Activity (Pseudo PEA), manual pulse check, Return of Spontaneous Circulation (ROSC) Conclusions: PoCUS plays in an important role in predicting ROSC for patients presenting in PEA. Given the importance of the distinction between true PEA and pseudo-PEA, the literature suggests implementation of training for providers in expedient and skillful use of PoCUS to identify pseudo-PEA may be beneficial provided that pauses in CPR are not prolonged

Corollary responsibility of the community college board of trustees

Educators frequently perceive community college trustees as grossly ignorant about higher education

Spacecraft Position Estimation and Attitude Determination using Terrestrial Illumination Matching

An algorithm to conduct spacecraft position estimation and attitude determination via terrestrial illumination matching (TIM) is presented consisting of a novel method that uses terrestrial lights as a surrogate for star fields. Although star sensors represent a highly accurate means of attitude determination with considerable spaceflight heritage, with Global Positioning System (GPS) providing position, TIM provides a potentially viable alternative in the event of star sensor or GPS malfunction or performance degradation. The research defines a catalog of terrestrial light constellations, which are then implemented within the TIM algorithm for position acquisition of a generic spacecraft bus. With the algorithm relying on terrestrial lights rather than the established standard of star fields, a series of sensitivity studies are showcased to determine performance during specified operating constraints, to include varying orbital altitude and cloud cover conditions. The pose is recovered from the matching techniques by solving the epipolar constraint equation using the Essential and Fundamental matrix, and point-to-point projection using the Homography matrix. This is used to obtain relative position change and the spacecraft\u27s attitude when there is a measurement. When there is not, both an extended and an unscented Kalman filter are applied to test continuous operation between measurements. The research is operationally promising for use with each nighttime pass, but filtering is not enough to sustain orbit determination during daytime operations

Estimating the Economic Viability of a New Crop Alternative for the U.S. Organic Market: Edamame - A Vegetable Soybean

whole farm modeling, edamame, Farm Management, Production Economics,

Cost Sensitivity Analysis on the Optimal Location of Technology Providers In Kentucky

A warehouse location model was utilized in order to expand upon previous research. The aim was to more accurately depicting the optimal location for an agribusiness firm providing precision agriculture technologies in the state of Kentucky. It was determined that the optimal solution was Muhlenberg County.warehouse location model, precision agriculture, agribusiness, Agribusiness,

NALNET book system: Cost benefit study

The goals of the NASA's library network system, NALNET, the functions of the current book system, the products and services of a book system required by NASA Center libraries, and the characteristics of a system that would best supply those products and services were assessed. Emphasis was placed on determining the most cost effective means of meeting NASA's requirements for an automated book system. Various operating modes were examined including the current STIMS file, the PUBFILE, developing software improvements for products as appropriate to the Center needs, and obtaining cataloging and products from the bibliographic utilities including at least OCLC, RLIN, BNA, and STIF. It is recommended that NALNET operate under the STIMS file mode and obtain cataloging and products from the bibliographic utilities. The recommendations are based on the premise that given the current state of the art in library automation it is not cost effective for NASA to maintain a full range of cataloging services on its own system. The bibliographic utilities can support higher quality systems with a greater range of services at a lower total cost

Buyer Perceptions of Supply Disruption Risk: A Behavioral View and Empirical Assessment

As supply chains become more complex, firms face increasing risks of supply disruptions. The process through which buyers make decisions in the face of these risks, however, has not been explored. Despite research highlighting the importance of behavioral approaches to risk, there is limited research that applies these views of risk in the supply chain literature. This paper addresses this gap by drawing on behavioral risk theory to investigate the causal relationships amongst situation, representations of risk, and decision-making within the purchasing domain. We operationalize and explore the relationship between three representations of supply disruption risk: magnitude of supply disruption, probability of supply disruption, and overall supply disruption risk. Additionally, we draw on exchange theories to identify product and market factors that impact buyers’ perceptions of the probability and magnitude of supply disruption. Finally, we look at how representations of risk affect the decision to seek alternative sources of supply. We test our model using data collected from 223 purchasing managers and buyers of direct materials. Our results show that both the probability and the magnitude of supply disruption are important to buyers’ overall perceptions of supply disruption risk. We also find that product and market situational factors impact perceptions of risk, but they are best understood through their impact on perceptions of probability and magnitude. Finally, we find that decisions are based on assessments of overall risk. These findings provide insight into the decision-making process and show that all three representations of risk are necessary for fully understanding risky decision-making with respect to supply disruptions

Enantioselective Iridium-Catalyzed Allylic Alkylation Reactions of Masked Acyl Cyanide Equivalents

The first enantioselective iridium-catalyzed allylic alkylation reaction of a masked acyl cyanide (MAC) reagent has been developed. The transformation allows for the use of an umpoled synthon, which serves as a carbon monoxide equivalent. The reaction proceeds with good yield and excellent selectivity up to gram scale for a wide range of substituted allylic electrophiles, delivering products amenable to the synthesis of highly desirable, enantioenriched vinylated α-aryl carbonyl derivatives